Healthcare Provider Details

I. General information

NPI: 1336932052
Provider Name (Legal Business Name): LBJ TRANSPORTATION USA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2025
Last Update Date: 05/26/2025
Certification Date: 05/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 RIVERPLACE BLVD # 105-1371
JACKSONVILLE FL
32207-9046
US

IV. Provider business mailing address

1200 RIVERPLACE BLVD # 105-1371
JACKSONVILLE FL
32207-9046
US

V. Phone/Fax

Practice location:
  • Phone: 904-604-8021
  • Fax:
Mailing address:
  • Phone: 904-604-8021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY JONES
Title or Position: PRESIDENT
Credential:
Phone: 470-420-3701